PRIORITY 7

What are effective ways to incorporate shared decision-making with parents and children/youth hospitalized on the general paediatric inpatient unit (GPIU)?

Shared decision-making (SDM) refers to the collaborative process between patients, families, and healthcare providers in making informed care and treatment decisions that align with patient’s values, preferences, and treatment goals. SDM can be facilitated in paediatric settings by providing and exchanging information; encouraging children and parent(s) to ask questions; and encouraging the expression of preferences.

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Gaps in Evidence

Evidence on SDM in paediatric care is limited, particularly for acute illnesses and in the GPIU hospital setting. Prior SDM research is limited to specific populations, such as children and youth with mental health problems, cancer, asthma, disabilities, or cystic fibrosis. Future research is needed on how to effectively incorporate SDM in GPIUs.

Directions for Future Research

Potential research questions and/or directions for future studies include, but are not limited to:

What tools, decision aids, and/or frameworks are available for SDM in GPIU? How are these being used to address biases and incorporate equity in GPIUs?
Does SDM improve outcomes of children cared for in GPIUs?
What is the current state of SDM in GPIUs across Canada?
How are clinical situations unfolding in GPIUs with SDM? How might a SDM tool improve partnership?

Inpatient Setting

What treatment options do families want explored, whether conventional, complementary, or traditional in origin?
How are handovers and rounds executed in ways that integrate SDM preferences and values from families and patients?
How does patient and family inclusion in rounds impact the knowledge and confidence of parents at discharge, and/or help families participate more competently and confidently in the child’s care?

Inclusivity

How are linguistic barriers and ethno-cultural factors being incorporated and accounted for in SDM?
How can SDM be implemented for different sub-populations (e.g. patients and families with limited English proficiency)?